BACKGROUND: Infection with certain Human Papillomavirus (HPV) type is strongly associated with the development of dysplasia and cancer of the cervix uteri. About 70 HPV types have been identified and some 25 of these have been found in the genital tract. HPV typing has diagnostic and prognostic importance to discriminate between 'low', 'intermediate', 'high' risk types. A Polymerase Chain Reaction-Reverse Dot Blot Hybridization (PCR-RDBH) method was developed for typing of HPV with consensus biotinylated primer generated PCR products in a single test. We attempted to know the clinical usefulness of PCR-RDBH and also compared PCR-RDBH with Hybrid captureTM system (HCS) method in same specimens. METHODS: HPV typing was performed on cervical swab samples obtained from 100 women with abnormal cervical cytology: 37 with Atypical Squamous Cells of Undetermined Significance (ASCUS), 14 with Low Grade Squamous Intraepithelial Lesions (LGSIL), 44 with High Grade Squamous Intraepithelial Lesions (HGSIL) and 5 with invasive carcinoma of the uterine cervix. HPV PCR screening was tested with consensus biotinylated primer. If HPV PCR screening was positive, RDBH was done for the typing of HPV. In RDBH, biotinylated PCR product was used in hybridization with a membrane on which 12 different oligonucleotide probes (type 6/11/16/18/ 31/33/35/39/45/51/52/56) of genital HPV types had been immobilized. Hybrid captureTM system (HCS, Digene Diagnostics) was used for screening of HPV. RESULTS: Of 100 abnormal cervical cytology specimens, the positivity of HPV PCR screening was 67%. In 52 specimens, HPV could be typed by RDBH. Type 16 was the most frequent and mixed infection was found in 6 cases, all combined with type 16. Among the 13 cervical cancer specimens confirmed by biopsy, 12 specimens was found to be infected high and intermediate risk types of HPV. In cervical swab, there was signifincant discrepancy in positivity of HPV infection between PCR-RDBH and HCS method. In 51 cases, negative for PCR-RDBH, 16 cases (31%) were positive by HCS. In 49 cases, positive for PCR-RDBH, 15 cases (31%) were negative by HCS. CONCLUSIONS: PCR-RDBH method can do HPV typing fast and easy with non-radioactive biotinylated primer in cervical swab specimens. It is shown to be useful method for HPV typing and have a high clinical applicability. The results between PCR-RDBH and HCS methods show a significant discrepancy, so further investigation is needed.
Biopsy ; Cervix Uteri ; Coinfection ; Consensus ; Female ; Humans* ; Mass Screening ; Membranes ; Oligonucleotide Probes ; Polymerase Chain Reaction ; Uterine Cervical Neoplasms ; Uterus

Recurrent ectopic pregnancy of cesarean scar is very rare and its therapeutic management is still not established. We reported the first case of recurrent cesarean scar pregnancy that was successfully treated with concomitant intra-gestational sac methotrexate-potassium chloride injection and systemic methotrexate injection. This case study provides physicians with a safe and effective minimally invasive treatment option for recurrent cesarean scar pregnancy.
Cicatrix* ; Female ; Methotrexate* ; Potassium Chloride ; Pregnancy* ; Pregnancy, Ectopic

The experience of pediatric deep brain stimulation (DBS) of the globus pallidus internus (GPi) in the treatment of early-onset DYT1 generalized dystonia is still limited. Here, we report the surgical experience of bilateral GPi-DBS under general anesthesia by using microelectrode recording in a 7-year-old girl with early-onset DYT1 generalized dystonia. Excellent improvement of her dystonia without neurological complications was achieved. This case report demonstrates that GPi-DBS is an effective and safe method for the treatment of medically refractory early-onset DYT1 generalized dystonia in children.
Anesthesia, General ; Child ; Deep Brain Stimulation ; Dystonia ; Globus Pallidus ; Humans ; Microelectrodes

No abstract available.
Facial Hemiatrophy* ; Lung*

Fowl typhoid (FT) reported since 1992 in Korea is a septicemic disease of domestic birds caused by Salmonella gallinarum (S. gallinarum). The purpose of this study was to investigate the biochemical characteristics and antimicrobials susceptibility of field isolates of S. gallinarum isolated by year in Korea. A total of 258 isolates of S. gallinarum from 1995 to 2001 showed the same pattern in the majority of biochemical test such as IMViC (indole, methyl red, Voges-Proskauer and citrate utilization), carbohydrate fermentation and amino acid decarboxylation, and these results were almost in accordance with the traditional biochemical characteristics of S. gallinarum strain. When the antimicrobial susceptibility test against 258 isolates of S. gallinarum was performed by the disk diffusion method using 12 antimicrobial agents, all isolates from 1995 appeared to be susceptible to all of the antimicrobial agents tested except for tetracycline and oxytetracycline, whereas the vast majority of isolates from 2001 showed the reduced susceptibility to ampicillin (13.0%), gentamicin (43.4%), kanamycin (69.6%), enrofloxacin (6.5%), ciprofloxacin (10.9%), norfloxacin (52.5%) and ofloxacin (82. 6%). The prevalence of the prevalence of completely resisyany isolates resistant isolates to one or more drugs rapidly increased from 0% in 1995 to 93.5% in 2001. The minimal concentrations range of the majority of antimicrobial agents to inhibit 50% (MIC50s) against S. gallinarum isolates increased from 0.06 -- 8 microgram/ml in 1997 to 2 -- 256 microgram/ml in 2001. Especially, MIC50s for gentamicin and fluoroquinolones of isolates from 2001 increased over 10-fold than those of isolates from 1997. Therefore, our results indicate that sorbitol fermentation and arginine decarboxylation showed the diversity by isolates and the vast majority of isolates from 2001 showed the reduced susceptibility to antimicrobials tested.
Animals ; Anti-Bacterial Agents/*pharmacology ; Chickens ; Korea ; *Microbial Sensitivity Tests ; Poultry Diseases/microbiology ; Salmonella/*drug effects/isolation & purification ; Salmonella Infections, Animal/microbiology

Chin ; Discrimination (Psychology) ; Genioplasty ; Humans ; Hypesthesia ; Lip ; Mandibular Nerve ; Mandibular Osteotomy ; Nociception ; Sensation

OBJECTIVE: The purpose of this study was to evaluate retrospective data concerning patients with adnexal masses that were managed surgically during pregnancy and their effect on fetal outcome. METHODS: Data were reviewed concerning pregnant women who required surgery at our hospital from January 1991 to December 2000 for an adnexal mass. RESULTS: In the recent 10 years at our hospital a total of 47 pregnant women aged 27.9+/-3.6 years were diagnosed with adnexal masses that required surgery. The masses were removed at 12.3+/-3.7 weeks of gestation and maximum diameter was 8.4+/-2.3 cm. The pathologic features of the 47 lesions were as follows : 17 mature cystic teratomas, 14 epithelial origins (12 serous cystadenoma, 2 mucinous cystadenoma), 9 functional cysts, 4 endometriotic cysts, 2 paraovarian cysts, 1 malignant neoplasm. Of the 41 patients for whom the outcome of pregnancy was available, 2 (4.2%) gave preterm birth before 37 weeks, while 4 (8.5%) experienced spontaneous abortion. There were not any perinatal death for the 43 infants. CONCLUSION: Although our studies are smaller for confirmation, so larger studies are required, but our results suggest that an adnexal mass may be associated with an adverse fetal outcome. Surgical intervention at<22 weeks of gestation might not have been related to the adverse fetal outcomes.
Abortion, Spontaneous ; Cystadenoma, Serous ; Female ; Humans ; Infant ; Mucins ; Pregnancy* ; Pregnant Women ; Premature Birth ; Retrospective Studies ; Teratoma

OBJECTIVES: Due to their developmental characteristics, adolescents have a higher probability than other age groups of experiencing injuries caused by accidents, violence, and intentional self-harm. The severity and characteristics of injuries vary by the intentionality and mechanism of injury; therefore, there is a need for a national-level estimate of the scale and the severity of injuries in adolescents that takes these factors into account. METHODS: By using data from the Emergency Department-based Injury In-depth Surveillance Data, National Emergency Department Information System, the Korean National Hospital Discharge In-depth Injury Survey, and cause of death statistics, we calculated the emergency department (ED) visit rate, hospitalization rate, and death rate of injuries per 100 000 adolescents for each injury mechanism. The calculated rates were used to generate the injury pyramid ratio (ratio of death rate to hospitalization rate to ED visit rate) to visualize the scale and the severity of the injury. RESULTS: The mortality rate in adolescents due to injury was 10/100 000; the corresponding rates for hospitalization and ED visits were 1623 and 4923, respectively, resulting in an injury pyramid ratio with the general pyramid form, with a 1:162:492 ratio of deaths to hospitalizations to ED visits. The mortality rate due to suicide/intentional self-harm was 5/100 000, while 35 were hospitalized for this reason and 74 made ED visits. The pyramid ratio of 1:7:15 for intentional self-harm/suicide showed a steep pyramidal form, indicating considerable lethality. The mortality rate due to motor vehicle collisions (MVCs) was 3/100 000; 586 were hospitalized for this reason, while 1023 made ED visits. The pyramid ratio of 1:195:341 for MVCs showed a gradual pyramid form, indicating that the lethality was low and the scale of injury was high. CONCLUSIONS: The main categories of injuries in adolescents were visualized in pyramid form, contributing to an understanding of the scale of each injury by mechanism in terms of levels of death, hospitalization, and ED visits. These findings will be helpful for understanding how to prioritize injuries in adolescents.
Adolescent* ; Cause of Death ; Emergencies ; Emergency Service, Hospital ; Hospitalization ; Humans ; Information Systems ; Intention ; Mortality ; Motor Vehicles ; Violence

BACKGROUND: Many surgical techniques for ischemic mitral regurgitation (IMR) have been used with their excellent results and advantages. Here, we report our simple posterior annuloplasty techniques using vascular graft strip with their early results. MATERIAL AND METHOD: Twenty two patients (13 male) underwent the operations for IMR (excluding the papillary muscle rupture) from December 2001 to January 2003. Preoperative risk factors were low ejection fraction (<35%, n=9), hypertension (n=13), diabetes (n=9), and renal failure (Cr>2.5, n=4). The wide dissection beneath the both vena cavae and interatrial groove after bicaval cannulation enabled the easy exposure of mitral valve even in the small left atrium. After eight or nine interrupted sutures in posterior annulus for anchoring the 6 mm width vascular graft strip, symmetric (n=8) or asymmetric (n=14) annuloplasty were done. Combined surgeries were CABG (n=21), Dor procedures (n=3), tricuspid valve annuloplasty (n=1), Maze operation (n=1), and aorto-right subclavian artery bypass (n=1). RESULT: Except for one surgical mortality, all the patients were doing well and the mean grade of regurgitation was decreased from 2.95 to 0.88, however the ejection fraction had not changed significantly just before discharge. Post-operative valve function evaluated before discharge revealed no residual regurgitation in 8 (including 1 patient with mild stenosis due to over reduction), minimal in 11, mild in 2, and mild to moderate regurgitation in 1. One patient who had ischemic cardiomyopathy and renal failure died of the arrhythmia during the hemodialysis. CONCLUSION: These observations suggest that the annuloplasty with vascular graft strip could be a safe and cost effective techniques for ischemic mitral regurgitation. However, the long term evaluation for the mitral valve function should be defined for the final conclusion.
Arrhythmias, Cardiac ; Cardiomyopathies ; Catheterization ; Constriction, Pathologic ; Heart Atria ; Humans ; Hypertension ; Mitral Valve ; Mitral Valve Insufficiency ; Mortality ; Myocardial Ischemia ; Papillary Muscles ; Renal Dialysis ; Renal Insufficiency ; Risk Factors ; Subclavian Artery ; Sutures ; Transplants* ; Tricuspid Valve

Transient myocardial ischemia during cardiac surgery causes a loss of energy sources, contractile depression, and accumulation of metabolites and H+ ion resulting in intracellular acidosis. The reperfusion following ischemic cardioplegia recovers intracellular pH, activates Na+-H+ exchange and Na+-Ca2+ exchange transports and consequently produces Ca2+ overload, which yields cell death. Among the various Ca2+ entry pathways, the Na+-Ca2+ exchanger is known to play one of the major roles during the ischemia/reperfusion of cardioplegia. Consequently, information on the changes in intracellular Ca2+ activities of human cardiac myocytes via the Na+-Ca2+ exchanger is imperative despite previous measurements of Ca2+ current of human single myocytes. In this study, human single myocytes were isolated from the cardiac tissues obtained during open-heart surgery and intracellular Ca2+ activity was measured with cellular imaging techniques employing fluorescent dyes. We report that the Na+-Ca2+ exchanger of adult cardiac myocytes is more susceptible to hypoxic insult than that of young patients.
Adult ; Anoxia/*metabolism ; Calcium/*metabolism ; Child ; Child, Preschool ; Female ; Human ; Hydrogen-Ion Concentration ; Infant ; Male ; Middle Age ; Sodium-Calcium Exchanger/*physiology